A Health Care Disgrace

Kevin Sack of the New York Times has a riveting and heartbreaking story on the front page of today’s edition about Texas parents in a desperate struggle to find health care for their 21-year-old cancer patient son as they face the prospect of their health insurance running out. Particularly outrageous is the treatment this family has gotten at the hands of one of the nation’s premier medical institutions:

Late in 2007, Jake’s doctors at Texas Children’s Hospital told him that they had done all they could and gave him a 20 percent chance of surviving the next year. The Walkers were not ready to quit, and sought out Dr. Lance C. Pagliaro, a specialist at M. D. Anderson.

Dr. Pagliaro recommended an experimental chemotherapy regimen, and Jake has shown no sign of cancer since the treatments ended in March 2008. “Needless to say, we’re very pleased with how he’s doing,” Dr. Pagliaro said.

But during Jake’s check-up in December, Ms. Walker told the hospital that her son would be uninsured at the end of January. She said a hospital official then told her that if she was not able to pay up front, she should take her son elsewhere.

Dr. Pagliaro pledged that he would do what he could to make sure that Jake would be seen. “To deny him the relatively inexpensive follow-up that is so crucial,” he said in an interview, “just makes absolutely no sense.”

But the doctor has yet to intercede with the business office about waiving fees, saying it would be premature. Last month, when the Walkers showed up for an appointment with Jake’s oncologist, only a last-minute dispensation enabled him to be seen without payment in advance. The Walkers left with the impression they would be billed $700; the hospital says it will be $1,507. In either event, they have no way to pay it.

The hospital has suggested that Jake have his next tests elsewhere and send the results to Dr. Pagliaro to review, with payment to be negotiated in advance.

This is not the first time we have heard of this kind of disgraceful behavior on M.D. Anderson’s part. Almost a year ago, after the Wall Street Journal did a front-page story describing similar tactics by M.D. Anderson, Senator Charles Grassley put the hospital on notice:

Sen. Grassley said, “the troubling thing about her story is that these were the actions taken by a hospital that’s funded through taxpayers’ dollars and charitable gifts.” A staffer told the Health Blog in an email that Grassley was “particularly shocked at the upfront-billing tactics” described in the WSJ article.

It will be interesting to hear what he has to say about this latest report.